Assistant Professor Sara Guilcher and Leslie Dan Faculty of Pharmacy PhD graduate Mary-Ellen Hogan were recently part of a winning research team. The team won a poster award at the 7th National Spinal Cord Injury Conference that took place in Niagara Falls on November 9-11, 2017.
The poster, “Examination of prescription drug use following a traumatic spinal cord injury using Ontario administrative health data”, was funded by a Connaught New Investigator Award and the Craig H. Neilsen Foundation Psychosocial Research Pilot Grant.
Spinal cord injury (SCI) is a devastating life event that often results in paralysis and impairments in autonomic, bowel, bladder, and sexual dysfunction. People with SCI experience complications (e.g., pain, depression, spasticity, pressure sores, urinary tract infections) and are at risk for polypharmacy. The extent to which polypharmacy and drug-related problems influence medication adherence, health and well-being outcomes, health care utilization, and costs are currently unknown in Canada for the spinal cord injury (SCI) population. Overall, medication use is an under-examined but significant concern post-SCI, which requires stronger levels of evidence to inform best practices for this population. To address this gap, the multi-year funded research program will examine factors related to medication management for SCI. Specifically, the purpose of this research was to examine the prevalence of polypharmacy for people with traumatic SCI following injury and to determine factors associated with polypharmacy following traumatic SCI.
Using administrative health data, the research studied 418 cases of persons with traumatic SCI during the observation window, with 56 per cent of individuals on 10 or more drugs following SCI. Continuity of care was significantly associated with polypharmacy, with a higher continuity of care reducing the risk of polypharmacy. The top drug classes prescribed were laxatives, opioid analgesics, cholesterol drugs, stomach acid suppressors, and stool softeners.
Over the next year, the research team will use administrative health data to expand the analysis to non-traumatic SCI and to those under 66 years of age, examine different definitions of polypharmacy, and estimate the proportion of persons with SCI receiving high risk drugs. They will also interview persons with SCI, clinicians and unpaid caregivers to explore experiences with medication management using qualitative methods.